Homelessness among veterans: post-traumatic stress disorder, depression, physical health and the cumulative trauma of military sexual assault.

Objective: The current literature does not account for how homeless
experiences in combination with military sexual assault (MSA) are associated with
posttraumatic stress disorder (PTSD), depression, and physical health among military veterans. Method: The survey sample included 251 female and 1,249 male U.S.
Armed Forces veterans in San Francisco, CA, and Chicago, IL, who reported their
housing status during the past 3 months. Three subgroups emerged: housed, those experiencing broad homelessness (e.g., home of another person, hotel), and those experiencing literal homelessness (e.g., shelter, abandoned building). Analysis included (a) six
multivariable logistic regressions to understand the relationship of homelessness and
mental and physical health and (b) six moderation multivariable logistic regressions
demonstrating the interaction of MSA, homeless experiences, and mental and physical health. Results: Female veterans who experienced literal or broad homelessness
and MSA were more likely to have PTSD, depression, and/or physical health symptoms than those who were housed and had not experienced MSA. Male veterans
who experienced literal or broad homelessness and MSA were more likely to have
PTSD, depression, and/or physical health symptoms than those who were housed
and had not experienced MSA. Conclusions: Findings demonstrate the cumulative
effect of homelessness and MSA, highlighting the need to assess for MSA among veterans experiencing homelessness, to provide trauma-informed care within homeless
services, and to support veterans in achieving secure housing.